The HPV (Human Papillomavirus) vaccination protects against infections that cause cervical, anal, throat, and other cancers, as well as genital warts. It is most effective when administered before exposure to the virus, typically in preteens aged 11–12, though it can be given up to age 45. The vaccine stimulates the immune system to develop long-lasting protection against high-risk HPV strains. Safe and effective, it significantly reduces the risk of HPV-related diseases. Widespread vaccination not only protects individuals but also reduces the overall prevalence of HPV infections, contributing to community-level immunity and cancer prevention on a larger scale.
Myth #1: HPV vaccination increases risky sexual behaviour and promiscuity.
Potential sexual disinhibition in teens is a fallacy that keeps coming up about HPV vaccination. Parents' concerns about potential promiscuity and an increase in risky sexual behaviour may result in lower immunization rates in younger years. Numerous studies have demonstrated that vaccinated people have safer sexual behaviours than unvaccinated people.
Myth #2: It is not required to vaccinate children before they are sexually active.The vaccination is most effective when administered before the onset of sexual activity. However, the age of first sexual contact varies among individuals, depending on their country and culture. Despite being the most prevalent sexually transmitted illness, HPV can spread non-sexually through shared clothing, fomites, and both horizontal and vertical transmission. Like other vaccines, this one is intended to provide long-term protection and should not be given near a potential infection. If the vaccination is provided sooner, fewer doses need to be given. Children should receive the two doses for better coverage and cost-effectiveness.
Myth #3: After the first sexual intercourse, the vaccine does not work anymore The vaccine has been proven to offer substantial protection among young women regardless of prior HPV exposure against cervical pre-cancer compared with HPV-naïve women, in whom protection is excellent. However, in women vaccinated at an older age (25 years and above), protection at the population level is low.
Myth #4: PAP smears and annual check-ups are anyway required, so there is no need for vaccinationPAP smears are a screening modality. It only addresses cervical cancer and not all HPV-associated diseases. In addition to detecting lesions early, the goal includes eliminating their chances of developing altogether. The vaccine helps in primary prevention of precancerous lesions of the cervix. Additionally, it may also prevent other HPV-related malignancies such as vaginal, vulvar, anal, penile, or oropharyngeal cancer that cannot be prevented through the detection and treatment at pre-cancerous stages.
Myth # 5: You cannot receive the HPV vaccine if you are or were previously infectedThe vaccine is effective against many strains. It can still protect you from infection with other strains, especially the ones associated with cervical cancer.
Myth #6: HPV vaccines may have long-term side effectsThe vaccines do not contain live virus. They have been in use since 1997. More than 25 years of data and experience with these vaccines and no reported side effects to cause concern. The vaccines are effective in targeting specific dangerous subtypes of HPV specifically.
Myth #7: Once vaccinated, I do not require regular PAP smears and annual check-ups. The HPV vaccination significantly reduces the chances of vaginal, vulval, and cervical lesions. However, regular screening and PAP smears are still warranted to rule out less common malignancies.
Myth #8: HPV vaccination can cause infertility or adverse events like autoimmune diseases and deathData from Denmark (published in 2021) states no association between HPV vaccination and primary ovarian insufficiency among more than 950,000 Danish women and girls. Extensive retrospective and prospective studies also suggest no associated risks between the vaccine and autoimmune disease.
Myth #9: Men do not get cervical cancer so they do not need a vaccineHPV is linked to at least several other malignancies, anal, penile, and oropharyngeal cancer. Additionally, as men serve as carriers of the virus, vaccinating them could contribute to achieving the goal of herd immunity, with a target of at least 80% coverage in girls-only vaccination and 60% in gender-neutral vaccination. A gender-neutral vaccination approach ensures protection of individuals of all gender identities and sexual orientations, both past and future, and doubles the potential for the broadest coverage. Boys should be vaccinated!
Myth #10: Natural HPV infection already creates a protective antibody response, so there is no need for vaccinationOne characteristic of HPV infection is that the virus stays localized — it doesn’t enter the body’s circulation or evoke visible local inflammation. Thus, an antibody response is low to absent. The natural immune response is insufficient to control for new infections and is inadequate to counter repeated infections.
Myth #11: I am in a monogamous relationship; I cannot contract HPV The average lifetime probability of acquiring HPV in women with one sexual partner is 84.6 % and in men, it is 91.3%. It is important for both the individual as well as the herd immunity for the HPV vaccine to be administered to all.
Dr. Madhavi Nair, Consultant - Surgical Oncology, Manipal Hospital Varthur